A veterinarian shortage: Federal, state programs aim to combat lack of rural practices

Megan Favignano @MFavignano

Saturday

Apr 29, 2017 at 8:00 AM

Studies show a significant shortage of food animal veterinarians in certain areas of the country. Find out why and what's being done to change it.

As one pet owner left the Cooper County Animal Hospital with their dog Friday morning, a group of cattle arrived to receive treatment.

Dr. Scott Fray has had the veterinary practice in Boonville, Mo. since 1994. When he started his career at a practice in Nebraska, Fray knew he wanted to be in a mixed practice, serving both large and small animals.

“The veterinary profession is a great profession and it’s done me well,” Fray said. “The big concern is … in the next 10 years or so I hope that they’ll be somebody that will come out and take my place.”

Fray fears he will have difficulty replacing himself when he retires because there is a shortage of veterinarians in rural areas.

Sally Gifford, a spokeswoman for the USDA National Institute of Food and Agriculture, said studies show a significant shortage of food animal, or large animal, veterinarians in certain areas of the United States.

State animal health officials, she said, can nominate a community to be identified as a shortage area with the USDA. The American Veterinary Medical Association lists five critical shortages in Missouri, or counties with zero veterinarians but more than 25,000 food animals.

A KEY ROLE

Dr. Neil Olson, dean of the University of Missouri College of Veterinary Medicine, said it’s imperative to encourage veterinarians to consider rural practices both to serve families in the region and for public health reasons.

Vets can help detect diseases that could affect an entire herd of cattle or could transfer from animals to humans in an area. Early detection can help prevent a major outbreak, Olson said.

“The veterinarian is the one that can help warn public health authorities,” he said. “It’s not only for the transmission of diseases but it’s also for food safety as well because these animals are going to eventually be providing animal protein to the consuming public and you want that to be as wholesome as one can possibly make it.”

Emily Bristol, an MU veterinary medicine student graduating next month, said she favors large animal and mixed animal practices. She will start working in June at a mixed animal clinic in New York state, near where she grew up. Bristol said the area serves a lot of small, traditional dairy farmers.

She echoed Olson’s sentiment about the important part veterinarians have in protecting public health. Bristol said there is a huge crossover between animal and human health.

“The general public is not aware of how much veterinarians play a role in keeping the food supply safe,” she said.

When an animal uses medication, farmers are supposed to wait before selling milk from the animal or slaughtering it, Bristol said. Veterinarians help educate farmers about that waiting period and ensure those rules are being followed, she added.

THE RURAL STRUGGLE

Dr. John Middleton, MU professor of food animal medicine and surgery, said he has seen veterinary practices have to treat both small and large animals because farmers may only need a large animal vet a couple times a year.

“One of the problems we have is in rural areas,” he said. “ The economy doesn’t support a veterinarian.”

In Fray’s experience, rural communities he’s worked in have had enough food animal or large animal veterinary needs to support a medical practice. He thinks it’s a misconception that there isn’t enough work available for vets in rural areas.

“There’s this general feeling that you have to work on small animals to pay the bills” at a rural practice “and I would argue that’s not true,” he said.

Fray personally likes the convenience a mixed animal vet offers. And, he thinks that type of practice works well in a rural area.

“A good percentage of our clients have both” large and small animals. “So they can call the same vet to treat their cows and their house dog and everything in between,” he said.

At Cooper County Animal Hospital, about a third of the clients have small animals, while another third have large animals and the remainder have both.

Middleton said veterinarians in rural areas need to be a “jack of all trades” and know how to treat both small and large animals.

Fray said rural community vets often have a more physically demanding job and are on call more frequently. Because of that, he said it can be difficult to attract someone to that type of lifestyle.

He also said the student debt to income ratio for veterinary graduates makes it challenging for rural areas to attract vets. Olson said families in those rural counties don’t make a lot of money.

“We have a situation where it’s not easy to get veterinarians out into those areas simply because of economic reasons,” Olson said.

Bristol said people occasionally question why she chose a field that calls for a lot student debt, especially when compared to the profession’s pay. She said it may seem illogical, but she loves the work.

“No one went to vet school to make a lot of money,” Bristol said. “We all come out with a huge debt load.”

Gifford said the USDA sees the debt load as a barrier for students interested in becoming a veterinarian.

“A leading cause for the scarcity in this profession is the heavy price tag that four years of professional veterinary medical training carries, which can average more than $150,000,” Gifford said in an email.

FINDING SOLUTIONS

There are state and federal veterinary medicine loan programs, which aim to encourage graduates to seek employment in rural communities.

The USDA’s Veterinary Medicine Loan Repayment Program, or VMLRP, received 192 applications during the state’s 2016 fiscal year. Of those, 47 received awards. Gifford said the program gave a total of roughly $4.3 million to those recipients, who had an average eligible debt of $108,129.

“Partial repayment of educational debts with a VMLRP award helps alleviate this debt burden and allows veterinarians to pursue careers in areas of the country where veterinary services are in short supply,” Gifford said in an email.

Veterinarians can apply for the USDA’s program award in exchange for working in a specific area designated as a shortage area. The application deadline for vets applying this year is May 26, Gifford said.

The Missouri Department of Agriculture’s Large Animal Veterinary Loan Repayment Program typically helps six students each year, accepting applications in the fall. Fray said that doesn’t make a huge dent in the shortage problem but it does help. He worked with the committee that pitched the program to legislators several years ago.

The state program gives each student $20,000 for living and educational expenses for each academic year. Those loans are forgiven if the students practice large animal veterinary medicine in an area Missouri designates as in need, which consists of rural areas.

The federal program started in 2010. Since then, Gifford said more than 300 veterinarians from the program have helped fill shortage areas in 46 different states.

Fray said the veterinary industry still discusses the shortage issue but said the industry’s concerns have “settled down” since loan repayment programs were implemented.

But Middleton said that funding has been cut in some years, depending on budget restrictions.

“While we have these incentive programs, they tend to be chronically underfunded,” Middleton said.

Middleton said legislators have aimed to address the shortage in other ways, including designating funds to MU for its large animal program for the past five years. Those funds helped the MU Veterinary Health Center build its large animal ambulatory facility, which opened about a week ago. That was a more than $2 million dollar project that provides a space for the center’s vehicles, which helps with biosecurity.

Olson said MU also has programs that aim to help combat that shortage in Missouri’s rural areas. But, the veterinary college can’t control every facet.

“At the end of the day, we don’t control what a graduate wants to do or where he or she goes,” he said.

MU has an Ag Scholars Program and offers travel grants to veterinary students wishing to gain more practical experience.

Additionally, Olson said MU likes to see students come from rural areas because that often means those individuals may return to that rural setting post graduation.

“The kind of graduate that goes to these areas is likely going to be the one that comes from that kind of a background,” Olson said. “It’s really in their blood. They are passionate about going back to a rural community.”

As MU considers students applying to its vet school, Olson said the university gives some preference to students from rural areas. Olson said it’s too soon to tell how much impact these initiatives have had as there needs to be about a decade of data before anyone can really measure the impact.

For the past five years, about 40 percent of MU’s vet graduates have stayed in Missouri to practice medicine, according to the College of Veterinary Medicine’s graduates survey results. Since 2011, the percentage of MU’s students who choose to work in a mixed animal practice has grown.

PURSUING A PASSION

Fray sees the recruitment challenges facing the veterinary industry as a way of knowing individuals working as vets truly enjoy what they do.

“It helps our profession attract people that have a true passion for it,” he said.

For Bristol, helping large and small animals is her passion. She’s known since she was a child that she wanted to become a veterinarian. She fondly remembers going with her parents when they took her family’s dogs and cats to the vet.

Bristol said her family’s vet played a role in her considering that career path. Olson worries that a lack of vets in rural areas will lead to fewer children thinking about the profession and in turn lead to fewer vets.

“Kids grow up and they don’t have” veterinarian “mentors. They didn't go with a veterinarian because there’s no veterinarian there,” Olson said. “It’s almost like a self perpetuating problem.”

Bristol discovered she enjoyed working with large animals and farmers when she was an undergraduate student studying in Ohio. She worked with dairy farmers in New York near where she grew up.

The role of a vet, Bristol said, has evolved to more than just treating sick animals.

“These people, it’s their livelihood. I want to help them be successful,” she said of farmers.

mfavignano@columbiatribune.com

573-815-1719

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